Food and Alcohol Disturbance in High School Adolescents: Prevalence, Characteristics and Association with Problem Drinking and Eating Disorders.

Food and alcohol disturbance (FAD) is characterized by the association of alcohol use with compensatory behaviors such as restricting calories, physical activity and purging. Despite not being part of the current nosography, research has grown in the past 10 years, mostly on college students' samples. In this study, we aim to describe the prevalence, characteristics and association of FAD with problem drinking (PD) and eating disorder risk (EDR) in a sample of Italian high school students. Participants were 900 high school students (53.6% males; mean age = 16.22) that were administered standardized questionnaires. Students who screened positive for PD, EDR and both were, respectively, 17.3%, 5.9% and 1.3%. Approximately one out four students reported FAD behaviors, mostly to control weight and by restricting calories, with higher prevalence and severity among those who screened positive for PD. Purging behaviors were rare overall (15.5%), but significantly more frequent in participants who screened positive for both PD and EDR (41.7%). FAD was more strongly associated with alcohol use severity than with ED symptom severity across all subgroups. FAD behaviors appear to be common in the Italian high school population and more strongly associated with PD. Future studies should investigate FAD's impact on adolescents' functioning and possible early interventions.

Validation of the Italian version of the Compensatory Eating and Behaviors in Response to Alcohol Consumption Scale (CEBRACS).

The aim of the study was to evaluate, in a representative sample of high school students, the psychometric characteristics of the Italian version of the CEBRACS scale (Rahal et al., 2011), a questionnaire investigating compensatory eating behaviors correlated with alcohol consumption. These behaviors are adopted to make up for calories consumed through the drinking of alcohol and/or to enhance the intoxicative effects of alcohol. Study participants were selected from an initial sample of 965 students. Out of the 965 youths originally recruited, 640 (376 males and 264 females) reported drinking alcohol over the previous 3 months, and were considered eligible for the purpose of the study. The following questionnaires were administered: CEBRACS, Alcohol Use Disorders Identification Test (AUDIT) (Saunders, 1993), and the Eating Disorder Inventory-3 (EDI-3) (Garner, 2004). Test/retest reproducibility was evaluated on a subgroup of 189 youths. The factorial structure, internal consistency, test­retest reliability and concurrent validity of CEBRACS were evaluated. Factor analysis of inter-item correlation indicated 5 factors as being better suited to describe data, with an estimated 68.85% variance: "Alcohol Effect, "Laxative Use", "Dietary Restraint and Exercise", "Diuretic Use", "Restriction and Vomiting". A high degree of reproducibility and homogeneity (ICC = 0.806; Cronbach's Alpha = 0.886) of the scale was detected. A significant correlation was revealed between CEBRACS, the three eating disorder risk scales comprised in EDI-3 and scores and clinical risk yielded by AUDIT. The overall reliability and validity of the CEBRACS scale was confirmed in an extensive sample of Italian students, highlighting a satisfactory construct validity, good internal consistency and good degree of reproducibility. In view of the relevance of the problem, associated with serious health risks, a more widespread investigation of the phenomenon should be conducted using evaluation tools of proven validity and reliability on both representative samples of the general population and clinical samples.